Treatment Approaches to Neurocognitive Disorders

Neurocognitive disorders (NCDs) represent a growing epidemic in the modern world, concomitant with increasing life expectancy. NCDs represent the newer term replacing dementia. A major NCD is the equivalent of dementia, whereas a mild NCD is a new addition to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). The approach to diagnosing NCDs should include a thorough medical examination targeting potentially reversible causes of impairment, as well as screening for cognitive impairment in the outpatient setting, with focus on memory and functional decline. NCDs tend to have comorbid neuropsychiatric symptoms that include depression, anxiety, psychosis, sleep disturbances, and apathy, which may reduce quality of life and accelerate out-of-home care. The provider needs to be aware of these potential comorbidities, and of the pharmacologic and nonpharmacologic treatment options.